As U.S. Ebola Fears Widen, Reports of Possible Cases Grow

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Passengers of United Flight 998 left customs holding doctor's notes at Newark Liberty International Airport Saturday afternoon after a passenger on the flight was tested for possible exposure to the Ebola virus.CreditCreditRobert Stolarik for The New York Times

DALLAS — In Washington, a patient who had traveled to Nigeria and who was suspected of having Ebola was placed in isolation at Howard University Hospital on Thursday. In New Haven, two Yale University graduate students plan to sequester themselves when they return this weekend from Liberia, where they have helped the government develop a system to track the Ebola epidemic.

And at Newark Liberty International Airport on Saturday, a sick man who had just arrived from Brussels was rushed to a hospital amid concerns that he was showing Ebola-like symptoms, a fear later dismissed by the Centers for Disease Control and Prevention.

With fears about Ebola widening across the United States, federal health officials said Saturday that they were receiving an escalating number of reports of possible Ebola infection, particularly after a Liberian man tested positive for the deadly disease in Dallas last week, the first Ebola case diagnosed in this country. Since the disease began spreading rapidly across West Africa this summer, the C.D.C. said, it has assessed more than 100 possible cases, but only the Dallas case has been confirmed.

But increased attention about the virus has jangled nerves around the country, particularly among West African immigrant communities and recent travelers to that region, and placed health care workers on a kind of high alert. “We expect that we will see more rumors, or concerns, or possibilities of cases,” Dr. Thomas R. Frieden, director of the federal C.D.C., said Saturday. “Until there is a positive laboratory test, that is what they are — rumors and concerns.”

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Dr. Thomas R. Frieden, director of the Centers for Disease Control and Prevention.CreditTami Chappell/Reuters

In a sign of the seriousness of the virus, the Dallas hospital where the Liberian man, Thomas E. Duncan, has been recovering changed the status of his condition on Saturday from serious to critical.

In the more than 100 inquiries the C.D.C. has received about possible Ebola, about 15 people were actually tested for the virus, officials at the disease centers said. In addition to doing their own testing on suspected cases, federal officials have helped more than a dozen laboratories around the United States do Ebola testing.

One of those cases was at Howard University Hospital, which said Saturday that it had “ruled out” Ebola in a patient who was admitted on Thursday. The patient, who had traveled to Nigeria, had been placed in isolation “in an abundance of caution,” said a statement by the university’s president, Dr. Wayne A. I. Frederick.

The Newark airport case only added to the heightened nervousness. After United Airlines Flight 998 from Brussels arrived in Newark shortly after noon, officials from the C.D.C. took a 35-year-old man who had been vomiting to University Hospital in Newark “as a precaution,” said Erica Dumas, a spokeswoman for the Port Authority of New York and New Jersey. The flight had 255 passengers and 14 crew members on board, the airline said.

Hospital officials later said that the man had symptoms “consistent with another, minor treatable condition unrelated to Ebola.” A child accompanying him had no symptoms. Both were released and will continue to be monitored, the hospital said in a statement.

Images of the scene quickly spread on the Internet. The New York Post put up a photo on its website showing the passenger being removed from an ambulance by workers wearing surgical masks and white hazmat suits. A passenger on the flight, Paul Chard, of Florida, posted a photo from the plane showing an officer standing in an aisle wearing blue plastic gloves.

Obama administration officials said they believe that screening of passengers in the affected countries in Africa, by taking their temperature and requesting information about their activities, is the best way to prevent the virus from spreading to the United States. But they said Jeh Johnson, the secretary of homeland security, is evaluating whether other measures, including more aggressive screening of arriving air passengers in the United States, might become necessary.

Meanwhile, health officials had narrowed the pool of people who were at a risk of exposure in Dallas — because they had contact with Mr. Duncan while he was infectious — to nine, all of whom were being closely monitored.

Initially, officials reached out to 114 people in the Dallas area who potentially had direct or indirect contact with Mr. Duncan after he arrived in the city on Sept. 20. They have reduced that number to about 50 — the nine at high risk because they had definite contact with Mr. Duncan and about 40 others considered at lower risk.

“We don’t know that they had contact, but because we’re not certain that they did not have contact, we will be monitoring them as well,” said Dr. Frieden. Some of those people included patients who had traveled in the ambulance that had carried Mr. Duncan to the hospital before it was taken out of service and cleaned.

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Thomas E. Duncan, who tested positive for Ebola, is being treated at Texas Health Presbyterian Hospital in Dallas. CreditCooper Neill for The New York Times

The nine people who were at the highest risk include Mr. Duncan’s girlfriend and three of her relatives, who stayed with him in their Dallas apartment, as well as medical workers.

On Friday, local officials moved those four people to a house in another part of Dallas. Amid criticism that health officials had delayed cleaning the apartment and that they had failed to care properly for the four people quarantined inside, workers in yellow protective suits began cleaning the unit on Friday.

The delay in cleaning the apartment was due in part to confusion and conflicting guidance over state and federal permits “This has been a paperwork nightmare,” Mayor Michael S. Rawlings of Dallas said. Obama administration officials said they were drafting new guidance to clarify their recommendations.

On Saturday, the administration appeared to end the delay in disposing of material that was potentially contaminated with Ebola in Dallas. Administration officials said they had issued an emergency permit allowing an Illinois company to transport large quantities of possibly contaminated items from the apartment where Mr. Duncan had stayed, as well as from the hospital where he is being treated, Texas Health Presbyterian Hospital.

The permit authorizes the Illinois company, Stericycle, based in Lake Forest, to transport large quantities of Ebola-contaminated waste from Texas Health Presbyterian. Officials would not disclose where the waste would be taken.

The permit specifies how the waste material should be handled and requires use of a particular disinfectant. The packaging requirements, though different from those in federal regulations, will provide “an equivalent level of safety,” the administration said.

Contaminated waste materials include medical equipment, bedsheets and “personal protective equipment” like gowns, masks, gloves, goggles and respirators. The material collected by the Cleaning Guys, the company hired to disinfect the apartment where Mr. Duncan had been staying, was being placed in sealed plastic barrels on a trailer attached to a truck, and the truck was being stored at an undisclosed location.

The slow pace of removing and transporting the tainted items was just one of several problems connected with the first case of Ebola diagnosed in the country.

Texas Health Presbyterian sent Mr. Duncan home when he first came to its emergency room on Sept. 25, after health workers failed to consider the possibility that he had Ebola. On Friday, the hospital acknowledged that both the nurses and the doctors in that initial visit had access to the information that he had arrived from Liberia but failed to act on it.

“Hospitals, health-care workers across the nation have to learn from this experience,” said Dr. David L. Lakey, the commissioner of the Texas Department of State Health Services.

Manny Fernandez reported from Dallas, and Robert Pear from Washington. Abby Goodnough contributed reporting from Washington, and Emma G. Fitzsimmons from New York.

A version of this article appears in print on , on Page A20 of the New York edition with the headline: As U.S. Assesses Ebola, Possible Cases Increase. Order Reprints | Today’s Paper | Subscribe